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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Systemic lupus erythematosus (SLE) flares can progress to life-threatening multi-organ dysfunction, particularly when lupus nephritis and diffuse alveolar hemorrhage (DAH) coexist. Cytokine-adsorptive hemoperfusion (HP) using HA-330 has emerged as an adjunct to immunosuppression in hyperinflammatory states but remains under-reported in lupus, especially in TB-endemic, resource-limited settings.
A 22-year-old woman with SLE (clinically diagnosed Class III lupus nephritis) presented with fever, oral ulcers, arthralgia, hemoptysis, and dyspnea. She had a history of pulmonary tuberculosis, recently relapsed, and was non-adherent to maintenance therapy. On admission: BP 100/60 mmHg, HR 124 bpm, SpO₂ 98% RA, BMI 17.8 kg/m². Laboratories showed creatinine 52.2 mg/dL, BUN 1.7 mmol/L, K⁺ 2.49 mmol/L, Mg²⁺ 0.39 mmol/L, iCa²⁺ 0.75 mmol/L, WBC 13.1 × 10⁹/L, Hgb 81 g/L, Plt 495 × 10⁹/L, ESR 138 mm/hr, and respiratory alkalosis (pH 7.57, pCO₂ 32 mmHg, HCO₃ 29.3 mmol/L, PaO₂ 94 mmHg on FiO₂ 98%). Proteinuria (UPCR 1.01 g/g) and imaging revealed bilateral infiltrates.
She was clinically diagnosed with a severe SLE flare involving Class III lupus nephritis, diffuse alveolar hemorrhage, and acute renal failure, on top of relapsed pulmonary tuberculosis with superimposed hospital-acquired pneumonia.
Initial therapy included high-flow oxygen, broad-spectrum antibiotics (Aztreonam + Cefepime, renally adjusted), anti-TB regimen excluding rifampicin, hydroxychloroquine, cautious corticosteroids (pulse withheld for ocular concern), and electrolyte correction.
Due to worsening hypoxemia, rising inflammatory markers, and evolving kidney injury, two sessions of hemodialysis with hemoperfusion (HD + HP) using HA-330 were performed as cytokine-modulating adjunct therapy. HP was well tolerated. Within days, oxygenation, and urine output improved; serum creatinine stabilized, inflammatory manifestations diminished, and pulmonary hemorrhage resolved. Electrolyte levels normalized, and the patient remained hemodynamically stable under continued immunosuppressive and anti-TB therapy.
This case demonstrates the potential of cytokine-adsorptive HP using HA-330 as an adjunct in severe SLE flares with DAH and renal involvement, conditions with high mortality and therapeutic delay. Targeted cytokine removal may hasten stabilization and facilitate safer immunosuppression. The coexistence of DAH, lupus nephritis, infection, and relapsed TB underscores management challenges in TB-endemic, resource-limited environments.Hemoperfusion with HA-330 may serve as an effective bridge to immunosuppression, warranting further research and institutional protocols on patient selection, timing, and session frequency to optimize outcomes in critical lupus.
